The promised land awaits . . . and waits Douglas Barnard, the business development manager for Australian HealthSolve, still stands by his remarks made two years ago about the danger of under-investment in IT in the health sector, but says the 1999 Collaborative Health Informatics Centre (CHIC) report at least proved a catalyst for change. "There is certainly an awareness out there that the IT spend should increase," he says. "It hasn't happened yet - there is no concrete evidence that the actual medical IT spend has increased since that press release went out [in April 2000] - but there is more awareness that it should happen." CHIC information manager Sarah Warner agrees. Warner says that, until recently, health executives saw their core business as providing health, with IT as an expense they just couldn't justify because they couldn't see the business value of it. Where IT has been implemented in health care, with its complex organisational structure and service delivery model, Australia has seen a series of implementations that have been less than successful in delivering valuable outcomes. This has generated a level of guarded cynicism at a senior administrative level and particularly at a clinical level.

"Because it has been difficult to implement IT into a relatively complex environment, there's been a reticence to do that without a rigorous business case and examples of where it has proved successful in the past," McGill says. "This is not an Australia-only [situation]. It's [one] that has been happening in many parts of the world with lots of examples of major disaster stories in terms of implementation and the IT not delivering on what is either expected or what's promised by IT vendors." However, while the 1999 study showed IT expenditure in the health organisations was static at that point, and there's been little substantial change in the last couple of years, CHIC CEO Anne McGill says the management's thought process and view of IT in those health organisations is at least finally changing. "Now they are beginning to see the strategic value of IT. The growth figure (see "Total Australian Health IT Market Forecast 1999-2004", page76) highlighted in the 2000 report shows there is going to be substantial investment in the next two to three years and obviously there are going to be great opportunities for the IT companies."